CY2026 - Multiple value sets for seemingly same concept "General or/and Neuraxial Anesthesia" - Do we need 2 valuesets or can it be combined into one?

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your question regarding CMS108v14, Venous Thromboembolism Prophylaxis; CMS190v14, Intensive Care Unit Venous Thromboembolism Prophylaxis; and CMS1218v2: Hospital Harm - Postoperative Respiratory Failure. As you noted, the names of the two value sets are similar. Both value sets contain general and/or neuraxial anesthesia procedure codes and share some overlapping codes. However, the exclusion criteria for each value set, as indicated in each value set’s metadata on the Value Set Authority Center (VSAC), are different, as outlined in the attached table. For example, the General and Neuraxial Anesthesia (OID: 2.16.840.1.113762.1.4.1248.208) excludes the local, regional and axillary anesthesia, while the General or Neuraxial Anesthesia (OID: 2.16.840.1.113883.3.666.5.1743) does not.
      As such, the intent of each of these two value sets is distinct, and we will not be combining the codes across the two value sets into one value set.
      Show
      Thank you for your question regarding CMS108v14, Venous Thromboembolism Prophylaxis; CMS190v14, Intensive Care Unit Venous Thromboembolism Prophylaxis; and CMS1218v2: Hospital Harm - Postoperative Respiratory Failure. As you noted, the names of the two value sets are similar. Both value sets contain general and/or neuraxial anesthesia procedure codes and share some overlapping codes. However, the exclusion criteria for each value set, as indicated in each value set’s metadata on the Value Set Authority Center (VSAC), are different, as outlined in the attached table. For example, the General and Neuraxial Anesthesia (OID: 2.16.840.1.113762.1.4.1248.208) excludes the local, regional and axillary anesthesia, while the General or Neuraxial Anesthesia (OID: 2.16.840.1.113883.3.666.5.1743) does not. As such, the intent of each of these two value sets is distinct, and we will not be combining the codes across the two value sets into one value set.
    • CMS0108v14, CMS0190v14, CMS1218v2
    • Confusion and potentially inaccurate calculations

      In CY2025 inpatient eCQM specifications - there are 2 similar yet for some reason different value sets. 

      Valueset Name Valueset OID eCQMs # of  Codes
      General and Neuraxial Anesthesia 2.16.840.1.113762.1.4.1248.208 HH-RF 43
      General or Neuraxial Anesthesia 2.16.840.1.113883.3.666.5.1743 VTE-1, VTE-2 50

       

      The primary differences between the valuesets are - 

      1. One has the word "and" the other has the word "or".
      2. One has 43 codes, the other has 50 codes. 
      3. There are 10 codes in the valueset that has "or" in it that are not in the value set with "and". 
      4. There are 3 codes in the valueset that has "and" in it that are not in the value set with "or".
      5. All other codes are common between the 2 valuesets. 

      As you can see this is very confusing. 

      Is there a reason there are 2 value sets for the seemingly exact same concept? If so, could you help us understand so we can make sure we factor that into the eCQM logic calculations. 

      Is this something that could be aligned int he future to have a single valueset for this concept?

        1. CQM8101_2025-08-18.png
          CQM8101_2025-08-18.png
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            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Manish Parekhji
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